How do I do breast compression?

Here are the steps to performing the breast compression technique:

Hold the breast, cupping the breast from underneath with your thumb on one side of the breast and your fingers on the other.

Watch for the baby’s swallowing. The milk flows more rapidly when baby is drinking with an open—pause—close type of suck. Open—pause—close is one suck; the pause is not a pause between sucks, but of milk flowing into his mouth before a swallow. You may notice the same pause yourself when fluid flows in as you drink deeply and continuously. If using compressions while pumping, watch for sprays of milk.

When baby is nibbling or no longer drinking with the open—pause—close type of suck, compress the breast gently but firmly (not so hard that it hurts) and try not to change the shape of the areola (the part of the breast near the baby’s mouth). With the compression, baby should start drinking again briefly with the open—pause—close type of suck.

Keep the pressure up until the baby no longer drinks even with the compression, then release the pressure. Often the baby will stop sucking altogether when the pressure is released, but will start again shortly as milk starts to flow. If the baby does not stop sucking with the release of pressure, wait a short time before compressing again.

Releasing the pressure allows your hand to rest and milk to start flowing to the baby again. If the baby stops sucking when you release the pressure, he will start again when he starts to taste milk.

When the baby starts sucking again, he may drink (open—pause—close). If not, rotate your hand position and compress again as above.

Continue on the first side until the baby does not drink even with compression. You should allow the baby to stay on that side for a short time longer, since you may occasionally get another milk ejection and the baby will start drinking again, on his own. If the baby no longer drinks, however, allow him to come off or take him off the breast.